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October 13, 2025
Payment of Appraisal Award Precludes Bad Faith Claim

To Seek Bad Faith Tort Damages There Must be Injury in Excess of Policy Benefits

Post 5205

Read the full article at https://www.linkedin.com/pulse/payment-appraisal-award-precludes-bad-faith-claim-zalma-esq-cfe-rkzrc and at https://zalma.com/blog plus more than 5200 posts.

In Keith Frederich v. Trisura Specialty Insurance Company, No. 24-40748, United States Court of Appeals, Fifth Circuit (October 7, 2025) explained that an insured cannot maintain tort claims against an insurer if the insured has received the full appraisal award, absent evidence of an independent injury.

FACTS

Keith Frederich sued his insurer, Trisura Specialty Insurance Company ("Trisura" ), for allegedly violating the Texas Insurance Code. He appealed the grant of summary judgment in favor of Trisura.

Trisura moved for summary judgment, arguing that its payment of the appraisal award plus interest foreclosed Frederich's claims. Frederich countered that Chapter 541 allows an insured to recover tort damages that are cumulative to, and distinct from, any breach-of-contract damages. The district court granted summary judgment in favor of Trisura, concluding that Frederich had received all benefits to which he was entitled through the appraisal process and had failed to establish an independent injury.

ANALYSIS

On appeal, Frederich contended that Chapter 541 allows an insured to recover tort damages that are independent and distinct from contractual damages for breach of contract.

Trisura argued that its payment of the appraisal award plus statutory interest foreclosed all of Frederich's claims under Chapter 541. The Fifth Circuit affirmed the district court's judgment, holding that an insured cannot bring tort claims against an insurer under Chapter 541 after receiving an appraisal award and applicable statutory interest, absent an independent injury.

The Fifth Circuit explained that an insured cannot maintain tort claims against an insurer if the insured has received the full appraisal award, absent evidence of an independent injury.

Frederich's argument failed under the Fifth Circuit’s decision in Mirelez v. State Farm Lloyds, 127 F.4th 949 (5th Cir. 2025). Like Frederich, Mirelez asserted he could recover tort damages even when an appraisal award, any applicable interest, and any payments due under the insurance policy were paid out.

Because Mirelez sought no actual damages other than the policy benefits paid in accordance with the policy's appraisal provision, he could not maintain a bad faith claim under either the common law or chapter 541.

Mirelez foreclosed the insured's appeal because even if the plaintiff in Mirelez had raised the same statutory-construction argument, the panel would have rejected it as foreclosed by the Texas Supreme Court's interpretation of Chapter 541.

In sum, Mirelez foreclosed Frederich's appeal. Absent an independent injury, an insured cannot bring tort claims against an insurer under Chapter 541 after receiving an appraisal award and applicable statutory interest.

ZALMA OPINION

Bad faith suits in Texas require, among other things, damages other than a common law breach of contract. When, as here, Frederich's claims were paid in full after appraisal. As a result he incurred no damages in excess of the claim amount which was paid in full plus interest.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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September 18, 2026
Expert May Only Testify to What Experience Supports

Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.

Posted on September 18, 2026 by Barry Zalma

See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html

In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.

The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.

Law

The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution

Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

00:05:14
1 hour ago
Fraudsters May Not Enjoin Suit Alleging Fraudulent PIP Claims

Defendants May Not Enjoin a Suit Alleging They Defrauded the Plaintiffs

Plaintiffs, automobile insurers, sued medical professionals and healthcare entities, alleging a scheme to submit fraudulent personal injury protection (PIP) bills and supporting documentation for services that were not performed or were medically unnecessary. The complaint asserted common-law fraud, violations of the New Jersey Insurance Fraud Prevention Act (IFPA), aiding and abetting fraud, unjust enrichment, and declaratory relief.

While the action was pending, Plaintiffs moved to stay and enjoin related PIP arbitrations. A magistrate judge recommended denial. in State Farm Guaranty Insurance Company v. Tri-County Chiropractic And Rehabilitation Center P.C., Civil Action No. 22-4852, United States District Court, D. New Jersey (September 15, 2026)

After the New Jersey Supreme Court decided Allstate New Jersey Insurance Company v. Carteret Comprehensive Medical Care, P.C., the federal court reopened the case and considered the parties’ supplemental...

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3 hours ago
No Good Judicial Deed Goes Unpunished

Violate Terms of Probation and Go to Jail

Post 4848

Posted on September 21, 2026 by Barry Zalma

See the full video at and at

Kindness in Sentencing is Often Abused and Probation Becomes Jail

In State Of North Carolina v. Tia Allen, No. COA24-1010, Court of Appeals of North Carolina (September 16, 2026) Tia M. Allen pleaded guilty on 18 April 2022 to several offenses under a plea agreement. The trial court consolidated the convictions, imposed an 11-to-23-month sentence,

On 6 February 2024, her probation officer alleged that Allen had paid nothing, failed to report, and incurred new criminal charges. At the 26 March 2024 hearing, counsel admitted Allen’s nonpayment but did not admit commission of the new offenses; the court did not inquire into the failure-to-report allegation.

Defendant did not deny this probation violation. Instead, when the trial court asked whether Defendant wanted to admit any of the alleged ...

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September 21, 2026
No Good Judicial Deed Goes Unpunished

Kindness in Sentencing is Often Abused and Probation Becomes Jail

Posted on September 21, 2026 by Barry Zalma

Post 4848

See the full video at and at at https://lnkd.in/gGJpiN_R and at https://lnkd.in/gb56mYsP

In State Of North Carolina v. Tia Allen, No. COA24-1010, Court of Appeals of North Carolina (September 16, 2026) Tia M. Allen pleaded guilty on 18 April 2022 to several offenses under a plea agreement.

On 6 February 2024, her probation officer alleged that Allen had paid nothing, failed to report, and incurred new criminal charges.

The court found all alleged violations, extended probation by 24 months, imposed five months’ confinement as special probation, required reporting after release, and ordered electronic house arrest.

LAW

A probation violation need not be proved beyond a reasonable doubt; competent evidence must reasonably satisfy the trial judge that the defendant willfully violated a valid probation condition.

An in-court admission of a willful violation eliminates the need for ...

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